Stalled Pfizer deal clouds Israel's hopes of swift herd immunity

JERUSALEM (Reuters) -A bid to secure more Pfizer/BioNTech doses for Israel’s world-beating vaccination drive has become mired in political squabbles, just as its leaders saw the coveted prize of “herd immunity” as within reach.

Although more than half the population has been inoculated, Israel may not be able to keep up the momentum of the roll out.

Paralysed by repeated elections and political infighting, Prime Minister Benjamin Netanyahu’s caretaker government has been unable to push through a deal for additional doses.

A source familiar with the issue told Reuters that the new deal is for around 2 million doses, following the 10 million or so already delivered. Israel and Pfizer have not disclosed the exact number of doses delivered so far.

Some of the additional ampoules have already been shipped to Israel but have not been paid for because feuding ministers won’t convene to approve the payment and officials are at odds over the contract. Pfizer has halted the rest of the shipments until it is paid.

This has led to finger-pointing among the country’s political leadership, as Netanyahu tries to put together a ruling coalition following Israel’s fourth election in two years.

Particularly sensitive is the fact that some of the stalled doses are earmarked for children.

Israel has a relatively young population – a third of the country is under 16 – and some experts say that it can’t reach herd immunity without protecting them.

Herd immunity refers to a situation where enough people in a population have immunity to an infection to be able to effectively stop that disease from spreading.

“If children will be able to get vaccinated that will probably bring us to herd immunity,” said Nadav Davidovitch, an epidemiologist and public health expert at Ben-Gurion University.

He said Israel should ensure there were enough vaccines for children, but added: “I don’t think there’s cause for alarm.”

In addition to Pfizer, Israel has secured millions more doses from Moderna and has reached an understanding with AstraZeneca over vaccine supplies.

DWINDLING TURNOUT

With more than half the 9.3 million population fully inoculated, Israel’s economy is largely open and COVID-19 cases are falling. But so is the vaccination turnout rate.

Israel began vaccinating in late December and quickly reached more than 100,000 people daily. In the last month the numbers have steadily dropped to around 20,000 daily.

Though the slowdown was expected as more people got the shot, health officials had expected a higher uptake by younger generations.

Among people in higher risk groups the turnout has been particularly high. Around 90% of over-50-year-olds have received at least one of two shots.

But the lower the age group, the lower the turnout. It ranges from 74% among 20 to 29-year-olds taking at least one jab to 56% of 16 to 19-year-olds, according to health ministry data.

“Younger people think the pandemic is behind us, they won’t get infected and if they do, it will be a light illness,” Hezi Levi, director-general of Israel’s health ministry, told reporters on Thursday.

Israel’s goal was to complete vaccination of over-16-year-olds by the end of May, around when health ministry officials said they expected to start vaccinating some 900,000 12 to 15-year-olds, pending FDA approval.

“There’s still some unused supply set for adults so if tomorrow morning we have to start vaccinating children we will have enough only for the campaign’s start,” Israel’s coronavirus czar, Nachman Ash, told Israel’s Army Radio on Wednesday.

BOOSTERS

Sharon Alroy-Preis, head of public health at the ministry, said the halted shipment could already be affecting inoculations of coronavirus-recovered adults who get one shot.

Concerned that global “vaccine nationalism” could squeeze Israel out of future doses, the health ministry also wants the additional doses in place, should people need booster shots to stay protected.

Last month, the EU changed its vaccine export control mechanism so it can now block exports to countries that have a higher vaccination rate than the EU. Israel falls into that category.

“Agreements are based on our production forecasts and the projected inventory, so governments can be confident we can meet our commitments while not impacting the agreed supply to other countries,” a spokesman for Pfizer said in an email to Reuters.

He also said the company was prepared to supply Europe with hundreds of millions of vaccines in 2022 and 2023.

Netanyahu has said he wanted to buy 36 million doses.

“There is now a line from here to Timbuktu and beyond of countries that want to finalise contracts and we are delaying irresponsibly. We must procure immediately and this does not cost much,” Israel’s prime minister said on April 5.

POLITICS AND PANDEMIC

But Netanyahu has locked horns with his defence minister and political rival Benny Gantz.

Gantz refuses to approve procurement before Netanyahu approves the appointment of an Israeli justice minister from Gantz’s party. Netanyahu is currently on trial accused of corruption. He denies all wrongdoing.

The finance ministry is also at odds with the health ministry on how many vaccines to buy.

The bickering is less over whether to secure vaccines for children and more about the cost-benefit analysis of securing booster shots.

Scientists still have not determined whether such booster shots will be necessary, and whether vaccines will have to be altered to provide protection against coronavirus variants.

“We have to have a reasonable model,” said an Israeli source close to government discussions about the Pfizer deal.

“It’s not like ‘okay, let’s buy whatever we can of whatever technology for 9 million people because we have 9.2 million people in Israel. That’s not a strategy a country should take.”

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